I’d like to propose a new concept - surgical training jetlag. This is where you change rotations during surgical training and have new supervisors, new tasks, different colleagues and different responsibilities. You move from a job where you have built a level of trust with your bosses, and you know what’s expected. You move to a job where you have to prove you are reliable and safe all over again, and where your bosses may not be as generous to begin with.

My head’s spinning and I feel like I want to vomit. That’s jet lag, right? Maybe a nice walk in the sunshine would help.

Last week I worked 63 hours in five days. I started work at 6:30 or before on four of those days. I attended two surgical tutorials. I assisted in two different liver transplants. Also, I made dinner on Sunday evening assisted a gorgeous one year old, who chanted “some cheese must go in the salad.”

Living the dream!

Mrs Poestop: I’m OK. My tummy’s a bit sore but that’s because my family is making me so angry and I have to clench my belly to hold it in.

Me: What about this big cut from the operation?

Mrs Poestop: Ow! Don’t you touch that! It’s sore.

Me: OK. How have you been apart from your tummy?

Mrs Poestop: I was fine until the other day when I had to go to the dentist. Then that’s how this all started.

Me: Do you know where we are at the moment?

Mrs Poestop: Of course I do! This is the hospital. They keep telling me it’s the hospital.

Me: That’s right. Good.

Mrs Poestop: Its only the ducks that cause trouble.

The colonoscope responds to my touch and winkles gently trough tricky corners of bowel.

The hot snare sits perfectly.

The adhesions drop away and display my critical view.

The bosses walk out, “Call me if you run into trouble.”

The scrubs and scouts know my preferences and act as if they’re important.

I am ruler of my domain. Space time bends to my will. I am surgeon, hear me roar.

On an entirely unrelated topic, I am leaving space in my blogging schedule for a series on surgical complications.

This changeover period is stressful. Everyone is on edge and the hospital starts to grind. We transition from interns who have worked eleven and a half months and are at the peak of their game to interns who have worked five days and are unsure if they should prescribe paracetomol.

As a corollary to this, everyone in a more senior position forces themselves to become more tolerant. There is suddenly no place for teaching lessons through snappishness. The correct answer to a confusing referral is always “I will come an see your patient.” The grumbling becomes subaudible. The teeth grinding less so.

This amnesty lasts as long as our heads don’t explode. Not sure how long that is. One of my anaesthetic colleagues had to resite five IV cannulas today on patients covered with a morse code of band aids and bruises. I had a doctor spell out her own name for me instead of the patient’s and I didn’t laugh. We can only keep the intracranial pressure down for so long.

To the interns of 2011: Happy holidays. Congratulations on the start to a new year. May your futures be successful and your prospects bright. And may you also become registrars one day and truly know how much we miss you.

This skill is a surprising advantage in a field where it is unexpected. I can figure out what patients want. I know how to make them to agree with me, if I want to, but I get more of a kick out of helping them choose what they want. I can usually make them feel better about the bad stuff, and laugh despite their stitches. And I can often get anaesthetists, and booking nurses and resident staff to do what I want, and still like me at the end.

Of course, I am still a surgeon, and I still have a surgical personality. I couldn’t beat around a bush if there was a tiger in it. In surgery, this helps. People need to be told the truth, simply. Surgeons need to be able to say fart, poo and wee (at least), and answer truthfully. Could it be cancer? Yes. Will I die of this? Yes. Should I trust Lucy? No, Charlie Brown.

In real life, this trait doesn’t help as much. Tactlessness is funny in your friends, but a mood killer in party conversation. Honesty can be mean.

The other classical surgical foible is arrogance, which I have in spades (reread paragraphs one and two if you are unsure). In the last week I have told three people that I have excellent communication, and that is what makes me a good surgeon.

Last night, I went out with a colleague and somehow decided to give her an honest critique of her private life. Luckily, she can communicate too, and told me to shut up.

Sorry, babe. I’m gonna go back to humble now.

MissZ thinks.

Z: Mummy, I really, really want you to win that test.

Me: OK. You know, in order to do that, I’m going to have to work really hard this year and go to lots of classes and study in my office, even though I prefer to spend time playing.

Z: Don’t worry, Mummy. I’m going to be grade one this year, and I’ll have swimming lessons and readers. I’ll be really busy, just like you.

- If I choose not to cut you open for your pain, it is not code for “You are faking it.” It is code for “I don’t think I can fix your pain with my knife.”

-Sometimes you are faking it, though.

- I don’t enjoy putting my finger in people’s bottoms, no matter how many times I choose to.

- I don’t blog identifiable things about patients. Even if they are clearly too stupid to read.

- If you are out for a smoke or drink when I come to see you, I will assume you are much improved.

To my colleagues:

- Female reproductive organs do cause pain. They really, really do. Come and see my patient.

- If you are able to diagnose patients over the phone based on my examination and history, you probably could set up an excellent telemedicine clinic. (COME AND SEE MY PATIENT)

- If you are mean to my intern, I will squash you like a bug. Don’t.

- It is not a competition to see who has the least patients. It is a competition to see who has the most satisfied, well-managed and well-informed patients.

- If you were an obstetrician/orthopod/ultrasonographer in another country, I don’t care. Don’t try to sell me your unregistered diagnosis.